Ethical Dilemma Case Stuy - A Jehovah's Witness refuses a blood transfusion Submit Assignment Due Friday  by  11:59pm Points 50 Submitting a file upload Objective Demonstrate understanding of professional and ethical responsibility Demonstrate critical thinking in the application of ethical principles to ethical decision making when presented with an ethical dilemma. Instructions Answer the questions at the end of this case study.  Write a paper that is 3 to 6 pages in length, created using APA format.  Use 1-inch margins, double spaced text, 12-point font, and Times New Roma font.  Include a reference page with a minimum of 3 relevant citations or quotations.  Create a cover page with student name, title of the course, title of assignment, date, and name/title of instructor. Submit your paper response to the assignment box on or before the due date.  Late responses will not be accepted. Refer to the grading rubric provided for this assignment Case Study "Juana" (fictitious name) a 20-year-old, Black Hispanic female, 32 weeks pregnant, was brought to the emergency department (ED) by the paramedics.  She arrived in the ED immobilized on a flat board with a hard cervical collar in place.  Juana was the driver of a sedan involved in a single-vehicle collision.  She stated she was driving at approximately 60 miles per hour on the highway and suddenly lost control of the vehicle and crashed into a light pole.  She also stated her head hit the windshield and shattered the glass. She denied loss of consciousness.  Upon her arrival in the ED, Juana was alert and oriented to person, place, and time and had a Glasgow Coma Scale of 15/15.  Her initial complaints were lightheadedness, weakness, left shoulder pain, and severe abdominal cramping that started immediately following the car accident.  She had a past medical history of sickle cell disease and no previous pregnancies.  Her lungs were clear bilaterally.  Juana's heart rate was 90 beats per minute (bpm), her respiratory rate was 28, and her initial blood pressure (BP) was 130/80, and fetal pulse rate was 90. Once the cervical spine films were taken and the flat board was removed, her BP reflected orthostatic changes of 100/60 and pulse of 120 bpm. Juana was placed on a 100% nonrebreather mask.  Peripheral intravenous lines were started bilaterally to replace fluid loss that was indicated by the change in vital signs.  It was suspected that she was bleeding internally into her thoracic or abdominal cavity.  Blood specimens were drawn and sent to the laboratory.  A hemoglobin of 6 g/dl and hematocrit of 21% indicated internal bleeding.  Ultrasound showed blood in the amniotic cavity and Doppler confirmed a fetal heart rate of 90 bpm indicating fetal distress.  The patient was informed by the medical team of the critical nature of her condition. The plan of care for her was an immediate blood transfusion and an emergency cesarean section. Matters became complicated when Juana informed the.

1. Ethical Dilemma Case Stuy - A Jehovah's Witness refuses a
blood transfusion
Submit Assignment
Due
Friday
by
11:59pm
Points
50
Submitting
a file upload
Objective
Demonstrate understanding of professional and ethical
responsibility
Demonstrate critical thinking in the application of ethical
principles to ethical decision making when presented with an
ethical dilemma.
Instructions
Answer the questions at the end of this case study. Write a
paper that is 3 to 6 pages in length, created using APA format.
Use 1-inch margins, double spaced text, 12-point font, and
Times New Roma font. Include a reference page with a
minimum of 3 relevant citations or quotations. Create a cover
page with student name, title of the course, title of assignment,
date, and name/title of instructor.

2. Submit your paper response to the assignment box on or before
the due date. Late responses will not be accepted.
Refer to the grading rubric provided for this assignment
Case Study
"Juana" (fictitious name) a 20-year-old, Black Hispanic female,
32 weeks pregnant, was brought to the emergency department
(ED) by the paramedics. She arrived in the ED immobilized on
a flat board with a hard cervical collar in place. Juana was the
driver of a sedan involved in a single-vehicle collision. She
stated she was driving at approximately 60 miles per hour on
the highway and suddenly lost control of the vehicle and
crashed into a light pole. She also stated her head hit the
windshield and shattered the glass. She denied loss of
consciousness. Upon her arrival in the ED, Juana was alert and
oriented to person, place, and time and had a Glasgow Coma
Scale of 15/15. Her initial complaints were lightheadedness,
weakness, left shoulder pain, and severe abdominal cramping
that started immediately following the car accident. She had a
past medical history of sickle cell disease and no previous
pregnancies. Her lungs were clear bilaterally. Juana's heart
rate was 90 beats per minute (bpm), her respiratory rate was 28,
and her initial blood pressure (BP) was 130/80, and fetal pulse
rate was 90. Once the cervical spine films were taken and the
flat board was removed, her BP reflected orthostatic changes of
100/60 and pulse of 120 bpm.
Juana was placed on a 100% nonrebreather mask. Peripheral
intravenous lines were started bilaterally to replace fluid loss
that was indicated by the change in vital signs. It was
suspected that she was bleeding internally into her thoracic or
abdominal cavity. Blood specimens were drawn and sent to the
laboratory. A hemoglobin of 6 g/dl and hematocrit of 21%
indicated internal bleeding. Ultrasound showed blood in the
amniotic cavity and Doppler confirmed a fetal heart rate of 90
bpm indicating fetal distress. The patient was informed by the
medical team of the critical nature of her condition.

3. The plan of care for her was an immediate blood transfusion and
an emergency cesarean section. Matters became complicated
when Juana informed the medical team that she was a Jehovah's
Witness and refused the proposed plan of care. The physician
then recommended the use of alternative blood products. Juana
insisted that this was also against her religion and she refused
the alternative treatments being offered. The medical team
advised her that Jehovah's Witnesses could choose certain blood
byproducts, such as albumin, cryoprecipitate, and globulin
(Watchtower Bible and Tract Society, 2004).
According to Juana and her husband, both believed that if she
accepted the blood transfusion or blood products she would no
longer be a Jehovah's Witness and would be condemned to hell.
The husband then presented the physician with Juana's blood
card, created by the Watchtower Bible and Tract Society, the
governing organization of Jehovah's Witnesses. The card stated
her advance directives, including the prohibition of blood and
blood products.
Juana's condition worsened within 2 hours of admission to the
ED. She went into labor and delivered a stillborn baby boy.
She was immediately transferred to the intensive care unit
where, despite continued aggressive attempts to stabilize her,
she went into cardiac arrest and died.
Questions
What is the ethical/legal dilemma presented in this case?
Do you support/oppose Juana's decision to refuse the blood
transfusion?
What ethical principles are involved in this case?
What are the obligations or duties involved in this case?
What are the consequences of each possible action?
What are the proper ethical actions? Support your arguments.
What can you do to assist the patient and family during this
difficult time?
Rubric

4. Ethical Dilemma Jehovah's Witness refuses blood transfusion
Ethical Dilemma Jehovah's Witness refuses blood transfusion
Criteria
Ratings
Pts
This criterion is linked to a Learning Outcome
Defines the ethical dilemma
Excellent
20.0
pts
Good
16.0
pts
Needs improvement
12.0
pts
Unacceptable
0.0
pts
20.0
pts
This criterion is linked to a Learning Outcome
Identifies stakeholders
Excellent
10.0
pts
Good
6.0
pts
Needs improvement
4.0
pts
Unacceptable
0.0
pts
10.0

5. pts
This criterion is linked to a Learning Outcome
Identifies solutions or alternatives
Excellent
25.0
pts
Good
15.0
pts
Needs improvement
10.0
pts
Unacceptable
0.0
pts
25.0
pts
This criterion is linked to a Learning Outcome
Compares and evaluates the ethical arguments
Excellent
20.0
pts
Good
12.0
pts
Needs improvement
8.0
pts
Unacceptable
0.0
pts
20.0
pts
This criterion is linked to a Learning Outcome
Problem solving, critical thining
Excellent

6. 20.0
pts
Good
12.0
pts
Needs improvement
8.0
pts
Unacceptable
0.0
pts
20.0
pts
This criterion is linked to a Learning Outcome
APA format
Excellent